Work-related skin disease is a common and widespread occupational illness; skin diseases are responsible for approximately 50 percent of workplace illnesses, and account for an estimated 25 percent of all lost workdays.[1] Occupational skin diseases affect workers of any age in any number or of work settings, from manufacturing to medical services – any setting in which there is contact with an irritating or hazardous agent. A workplace skin disease can manifest in seconds (after contact with a harmful agent such as radiation or an acid) or take decades to develop – eventually resulting in lesions or cancer.[2] Contact dermatitis is the most common form of work-related skin disease. However, there are some things you can do to protect yourself from work-related skin diseases.

Steps

Part 1

Understanding the Risks

1

Recognize the symptoms. Symptoms of work-related skin disorder can be varied, as varied as the causes themselves. In general, the hands, fingers, wrists, forearms, forehead, face, and V of the neck (or any place on the body in which skin may have come in direct contact or the dust or fumes of an allergen) are the most at risk of developing contact dermatitis, so look for symptoms on these areas first.[3] Most often the symptoms will be isolated to a specific area of the skin. Symptoms may be immediate, or they may linger for a few days. Look for symptoms such as the following:[4]

Rash.

Itching.

Swelling.

Bumps or blisters, sometimes filled with clear fluid.

Hot or tender skin.

Lesions.

Burns.

Skin discoloration.

2

Understand predisposing factors. There are several predisposing factors that may make one more susceptible to work-related skin disease.[5][6]

Age. In general, younger workers are more inexperienced and more likely to take risks on the job site, which leaves them more prone to come into contact with harmful pathogens on the job site.

Skin type. In general, lighter skin color is more susceptible to pathogens on the job site than a darker skin color.

Pre-existing conditions. Pre-existing conditions may weaken your bodies immune system against unwanted pathogens. In addition, employees with chronic skin conditions (such as acne or rosacea) are more likely to develop skin reactions.

Extreme temperatures and humidity. Very low or high humidity and extreme heat or cold can cause chapping and dryness of the skin, thus weakening your skin’s natural barriers against pathogens.

Working conditions. A clean workplace is less likely to be contaminated with toxic or allergenic chemicals. In some industries, working conditions may expose you to chemicals, such as agriculture, mining, and manufacturing.

3

Know the risks associated with your particular profession. Because work-related skin diseases are varied, each occupation carries its own risk. For example, medical professionals are more likely to develop immediate skin reactions from harmful agents such as radiation or solvents, and less likely to develop skin reactions that can take a long time to develop, such as exposure to sunlight or heat. Know the particular causes and risks associated with your profession, and the accompanying symptoms.[7]

For example, wearing rings is not advised for employees in so-called “wet work” (work that involves extensive exposure to moisture) because water and soap can collect under the rings and become a breeding ground for bacterial and fungal infections.

Part 2

Identifying the Causes

1

Be aware of extreme heat. Heat causes sweating, and in environments in which there is little evaporation of the sweat, chafing can occur when skin rubs against open skin. Chafing can lead to a secondary bacterial or fungal infection. These infections typically develop in the underarm area, under the breast, in the groin and between the buttocks – areas which typically trap sweat in.[8]

2

Watch out for cold conditions. If exposed to cold for a long period of time, your skin can develop a reaction known as Cold Urticaria, which typically manifests in reddish, itchy welts or hives. Outdoor workers and those occupations which require swimming in cold water are particularly at risk.[9]

3

Notice your exposure to excessive moisture. Prolonged exposure to moisture can lead to skin breakdown and disease as seen in Cold Urticaria. Food handlers, dishwashers, hairdressers, and those in the medical profession (who are exposed routinely to various types of moisture, such as urine or stool, perspiration, mucus, or saliva) are particularly at risk.[10]

4

Watch for exposure to "poisonous" plants. Exposure to plants belonging to the Rhus genus (poison ivy, poison oak, etc.) can cause contact dermatitis, the most common occupational skin disease – typically manifesting in a rash at the site of exposure. The rash improves typically when the allergen is removed.[11] Outdoor workers, including firefighters, park and highway maintenance workers and farmers are most at risk of developing contact dermatitis, a condition caused by exposure to foreign substances.[12]

Ensure that you're not exposed to ionizing radiation. Radiation dermatitis is caused by external beam ionizing radiation. It typically manifests as a burn or a tissue injury (accompanied by welts, swelling, cuts and scrapes and pain).[13] Medical personnel such as radiation technicians, welders, and workers in the nuclear energy industry are most at risk of developing radiation dermatitis.[14]

5

Note potential irritants. Irritants exist in many different forms and can cause a variety of reactions. They can be classified as either strong or weak, depending upon the type of reaction elicited (either immediate or long-term).

Severe irritants. Severe skin irritants, such as strong acids and alkalis, heavy metals, oil, grease, or other strong material substances tend to cause immediate red blisters or burns. Like other causes of contact dermatitis, these symptoms can improve on removal of the allergen. Factory workers and laboratory technicians are most at risk of developing contact dermatitis caused by severe irritants.[15]

Weak irritants. Weaker irritants, such as soaps, detergents, solvents, synthetic oils, heat, and sunlight do not cause immediate skin reactions, but tend to cause skin changes over a long period of time. Pigment discoloration or skin cancer can take decades to develop in workers with prolonged exposure. Physicians, nurses, waiters, dishwashers, food handlers, and outdoor workers are most at risk of developing contact dermatitis caused by weaker skin irritants.[16]

6

Consider how much time you spend in the sun. Sunlight exposure is a common cause of work-related skin problems that can result in skin changes, such as pigment changes or skin cancer, when exposed to for a long period of time. Outdoor workers, including postal workers, landscapers, and construction workers, and long-haul drivers are most at risk of developing contact dermatitis caused by sunlight.[17]

Part 3

Avoiding Exposure

1

Watch others work. If you are new to a work environment, you can learn a lot by watching other employees work, particularly those who have worked many years in the same industry. Observe what kind of care they take to avoid contact with allergens, or, in some cases, learn what not to do by seeing the risks they take. Before exposing yourself, you can see if their skin comes into contact with a substance; then decide for yourself if you want to modify the process, substitute a substance (if allowed), or use additional personal protective equipment.[18]

2

Eliminate allergens. If you suspect contact dermatitis or are worried about exposure to a substance, do what you can to eliminate that substance from your work environment or minimize your contact with it. In most cases your employer should have procedures in place your contact with harmful substances, such as those put in place through the Occupational Safety and Health Administration.[19]

3

Adjust your workspace. If you or your employer are unable to eliminate the allergen or harmful agent altogether, steps should be taken to adjust your work environment or isolate the hazard from the workers. The following are options of measures that can be taken:[20]

Technical measures. Adapting technical procedures that can isolate the agent, such as encasing the harmful agent in another substance or tunneling the harmful agent through an exhaust fan.

Organizational measures. In some workplaces, only qualified employees (or those who have shown competence to work around a specific agent) are allowed to perform specific tasks in the workplace. This minimizes the potential risk of exposure for other employees in the workplace.

Personal measures. In some cases, simply increasing the amount of personal protective equipment (known as “PPE”) that employees are required to wear can minimize exposure to the allergen. For example, a face mask can minimize an employee’s exposure to harmful vapors or fumes from a harmful agent.[21]

4

Speak to your boss or supervisor about your concerns. If you are concerned about your exposure to certain pathogens in your workplace, speak to you boss or supervisor immediately. Your boss or supervisor should be acquainted with the particular hazard, and can provide specific information and protocol regarding exposure. Workplace safety is regulated and monitored through the Department of Labor (DOL) and the Occupational Safety and Health Act (OSHA); your employer has a responsibility (and in most cases, is federally mandated) to maintain a safe and healthy workplace. Most employers in the nation come under the jurisdiction of OSHA, with a few exceptions in the mining and transportation industries and a few public employers.[22]

For more information regarding OSHA standards, see the OSHA website through the Department of Labor: https://www.osha.gov/

Part 4

Protecting Yourself

1

Wear gloves and protective clothing. However, even protective equipment designed to protect employees from harmful agents have their shortcomings. The following steps should be taken to ensure the protective equipment has maximum efficacy:[23]

Protective equipment should be modified and sized to fit the individual employee. Equipment that does not fit an employee (either too big or too small) can leave the employee vulnerable to direct or indirect contact (fumes or vapors) of harmful agents.

Protective equipment should be worn in the way you were instructed to use it by your employer or OSHA. If it is stipulated that a face mask must be worn when working around a particular agent, for example, don’t pull it down or up. If it is uncomfortable, ask your employer to modify the size or try a different brand.

Replace protective equipment as needed or as stipulated. If a glove used to handle one substance comes in contact with another, it might cause a harmful reaction.[24]

2

Moisturize. Keep your skin healthy; healthy skin is less likely to react when it comes in contact with irritants. Cuts and scrapes (such as those caused by dry skin) can be a breeding ground for unwanted pathogens. Applying lotion or cream prior to work can help prevent cracks from dry skin and help your skin maintain its protective strength; but be careful to dry your skin thoroughly before starting work.[25]

3

Wash your hands. Wash your hands frequently throughout the day, and immediately wash your hands after coming in contact with an irritant. Appropriate hand washing is key to preventing the transfer of pathogens. Proper technique is key to removing germs. Follow this procedure for effective hand-washing:[26]

Wash with soap and water for at least 20 seconds.

Apply soap and lather hands by rubbing together with soap. Be sure to lather all parts of hands including fingers and scrub for at least 20 seconds (the amount of time it takes to hum the "Happy Birthday" song twice).

Rinse hands under running water.

Dry hands thoroughly. Wet hands are more likely to spread germs, so dry your hands thoroughly using a paper towel. Since regular towels are used and reused, they can be a breeding ground for pathogens.

4

Have a plan if exposure does happen. If you do come in contact with a harmful agent, time is key to minimizing your skin’s reaction. If you work around pathogens on a routine basis your workplace should have an exposure policy; find a copy of this policy. Have it memorized or make sure it is posted in a clear place in case of exposure. The course of action might be different depending the pathogen involved, but in most cases washing your hands with soap and water vigorously will be the first step.

5

Seek treatment. In cases of exposure, therapeutic measures (such as applying topical ointments or dressings) can provide relief, but a long-term cure depends on identification and avoidance of the harmful agent.[27] If you are able to identify and isolate the allergen or offending agent in your workplace, avoid contact with it immediately. In most cases of contact dermatitis the symptoms should disappear after you are no longer in contact with the pathogen.[28] If you are unsure about the cause, in most cases direct skin testing (patch or scratch) or radioallergosorbent testing may help to identify a specific trigger.[29] Contact your doctor if:

If the symptoms persist after two weeks. In this case other causes outside your workplace should be explored, and your doctor can help you identify the cause.[30]

If you came into contact with metals such as nickel or chrome. In part because these metals are ubiquitous, they may cause a reaction that is prolonged. Your doctor can help you identify alternatives or means of protection from these metals.[31]

If the reaction to the offending agent is particularly malignant or painful (such as a lesion, cut, or burn) and may require immediate medical attention.